Provider Demographics
NPI:1245507755
Name:BRICK, MARIANNE ELIZA (DVM)
Entity type:Individual
Prefix:DR
First Name:MARIANNE
Middle Name:ELIZA
Last Name:BRICK
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8520 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-3809
Mailing Address - Country:US
Mailing Address - Phone:916-961-1541
Mailing Address - Fax:916-961-8521
Practice Address - Street 1:8520 MADISON AVE
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-3809
Practice Address - Country:US
Practice Address - Phone:916-961-1541
Practice Address - Fax:916-961-8521
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11176174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian